title: Quality of life in seizure-free patients with epilepsy on monotherapy.
abstract: Epilepsy is a multifaceted chronic disorder which has diverse and complex effects on the well-being of the patient. Although it is evident that seizure type and frequency play a critical role in the quality of life (QOL) of patients with epilepsy, it is less clear what the major determinants are that influence QOL in seizure-free patients receiving monotherapy. The aim of this study was to evaluate demographic, clinical, and socioeconomic factors influencing the QOL of seizure-free patients receiving monotherapy. All participants were patients from four medical centers who had epilepsy, were on monotherapy, and had been seizure-free for at least 1 year. Responders completed three questionnaires on demographic and clinical information, QOL, and antiepileptic drug (AED) side effects during routine follow-up visits in the epilepsy clinics. We present the data of 103 patients: 59 females (57.3%), mean age 37.75+/-13.66 years. Treatment side effects and unemployment (p<0.0001, p=0.037, respectively) were significant predictors for poor overall QOL, whereas age, gender, education, family status, comorbidity, seizure type, age of seizure onset, and epilepsy duration did not significantly affect overall QOL. There was no significant difference in side effects and QOL between patients receiving older versus newer AEDs. Ninety-four (92.2%) patients reported experiencing at least one side effect of AEDs when queried about specific symptoms, while only 11 (10.7%) patients replied affirmatively when asked whether they experienced "any" side effects. The most common side effects involved the central nervous system. In conclusion, this study reveals that the most significant factor influencing the QOL in seizure-free patients on monotherapy is AED side effects. QOL is a crucial component in the clinical care of patients with epilepsy, and physicians should take the time to ask specific questions on side effects of AEDs.
authors.affiliation: Department of Neurology, Tel Aviv Medical Center, Tel Aviv 64239, Israel. eitanman1@gmail.com
authors.forename: Eitan
authors.initials: E
authors.lastname: Auriel
authors.forename: Hagay
authors.initials: H
authors.lastname: Landov
authors.forename: Ilan
authors.initials: I
authors.lastname: Blatt
authors.forename: Jacques
authors.initials: J
authors.lastname: Theitler
authors.forename: Revital
authors.initials: R
authors.lastname: Gandelman-Marton
authors.forename: Vladimir
authors.initials: V
authors.lastname: Chistik
authors.forename: Naum
authors.initials: N
authors.lastname: Margolin
authors.forename: Bela
authors.initials: B
authors.lastname: Gross
authors.forename: Yisrael
authors.initials: Y
authors.lastname: Parmet
authors.forename: Fani
authors.initials: F
authors.lastname: Andelman
authors.forename: Miri Y
authors.initials: MY
authors.lastname: Neufeld
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use; D014478:Unemployment; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D000077213:Lamotrigine